TATA AIG GENERAL INSURANCE COMPANY LIMITED

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Proposal Review For Bundled Auto Secure - Private Car Policy (1 Year Term for Own Damage & 3 years
for Third Party)
PR/23/6201129836 R 26/05/2023
Customer Details PR Producer Details
Customer Name CHEMWIT CONTRA CORROSIONS Producer Code 0032878000
Customer Contact 9891048019 Producer Name KARTIK
Customer Email anilmehrachemwit@yahoo.com Producer Contact 9654699600
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PLOT NO- 133, SECTOR-7A 121006 Producer Email sandeepn8102@gmail.com
Customer Address
FARIDABAD HARYANA
Nominee/Appointee Name N/A Vehicle Details
Vehicle Registration Number NEW
OS
Proposal Details HYUNDAI / ALCAZAR / SIGNATURE
Make & Model
Plan Name PackagePolicy O 7 STR 1.5 PETROL DCT / PETROL
OD Risk Start Date 26/05/2023 Date of Purchase/Registration 26/05/2023
A
OD Risk End Date 25/05/2024 Date of First Registration(in Case of
N/A
Used Car)
TP Risk Start Date 26/05/2023
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Mfg Year 2023
TP Risk End Date 25/05/2026
Cubic Capacity/KW 1482
Premium Amount 41,889.12
Engine No. G4LHPM541279
IDV Details
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Chassis No. MALPC816VPM852495
IDV of Vehicle 1,925,000
Bi-Fuel/CNG/LPG Kit 0
Financer Details
Financer Type N/A
Electrical Accessories IDV 0
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Financer Name N/A

Non-Electrical Accessories IDV 0
Loan Account Number N/A
Trailer IDV 0

Addon Details
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CPA Details
Addon Bundle Name SAPPHIRE ++ choice1
Compulsory Personal Accident N/A
CPA Tenure N/A
Owner Driver Declaration N/A
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PREMIUM BREAK UP
Section - I OWN DAMAGE (A) Section - II LIABILITY (B)
Own Damage Premium on Vehicle & Accessories Third Party Premium
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Basic OD Premium 9,214.01 Basic TP premium 10,640.00

TOTAL OWN DAMAGE PREMIUM (A) 9,214.01 PA Benefits
Section - I ADD ON COVERS (C) PA cover to unnamed passengers (IMT 16)
No. of passengers: 7 1,050.00
Add: Depreciation Reimbursement (TA 01) 5,775.00
CSI per passenger: 100,000.00
Add: Return to Invoice (TA 05) 2,310.00
Legal Liability
Add: Loss of personal belongings (TA 09) 135.00 Add: Legal liability to paid driver (IMT 28)
Sum Insured: 10000 150.00
Number of persons: 1
Add: Emergency transport and hotel expenses (TA 10) TOTAL LIABILITY PREMIUM (B) 11,840.00
Any One Accident : 5000 135.00
Any One Year : 10000 NET PREMIUM (A+B+C) 35,499.00

Add: Key Replacement (TA 15) IGST@ 18% 6390.00

315.00
Sum Insured: 25000 per occurrence limit 50% of SI TOTAL POLICY PREMIUM 41889.00
Add: Engine Secure (TA 16) 1,925.00 136.88
Road Side Assistance
Add: Tyre Secure (TA 17) 2,887.50
(Inclusive of All Applicable Taxes)
Add: Consumable expenses (TA 18) 962.50
Add : Repair of Glass, Rubber & Plastic Parts (TA08) 0.00
TOTAL ADD ON PREMIUM (C) 14,445.00
Note: Above mentioned Premium is subject to Positive vehicle inspection, if required as per Underwriting Gruidelines.

TATA AIG General Insurance Company Limited,

Regd. Office: 15th floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Marg,Off Senapati Bapat Marg, Lower Parel, Mumbai- 400 013.
IRDAI Regn. No.108, CIN No.: U85110MH2000PLC128425, PAN: AABCT3518Q, UIN No.: IRDAN108RP0006V02201819
Website : www.tataaig.com 24X7 Tollfree Helpline 1800-266-7780 E-mail: customersupport@tataaig.com
 TATA AIG GENERAL INSURANCE COMPANY LIMITED

Important Note :
Insurance is subject matter of the solicitation. For more details on benefits/exclusions, risk factors, terms and conditions please refer policy wordings/sales brochure
carefully before concluding a sale. You are requested to visit our website www.tataaig.com for policy wording.
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This is a system generated Proposal Review worksheet and does not require signature .

Premium and Risk period may change at the time of issuance of Policy.
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This document is only a proposal which can not be considered as authorized Policy Schedule. Kindly visit our website or contact TATA AIG authorized dealers/Agents
to opt for the Policy Schedule. For more terms and condition please refer sales brochure/ policy wordings carefully, before concluding a sale.
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TATA AIG General Insurance Company Limited,

Regd. Office: 15th floor, Tower A, Peninsula Business Park, Ganpatrao Kadam Marg,Off Senapati Bapat Marg, Lower Parel, Mumbai- 400 013.
IRDAI Regn. No.108, CIN No.: U85110MH2000PLC128425, PAN: AABCT3518Q, UIN No.: IRDAN108RP0006V02201819
Website : www.tataaig.com 24X7 Tollfree Helpline 1800-266-7780 E-mail: customersupport@tataaig.com